Hepatocellular adenoma : new understandings of molecular pathology and novel model of clinical diagnosis and therapy.

Hepatocellular adenoma (HCA) is the most common benign hepatocellular tumor, and its causes remain unclear. In Western countries, HCA is usually seen in the women of reproductive age who have a history of long - term use of oral contraceptives ( OCs) . In the latest 2010 WHO Histological Classification of Hepatobiliary Tumors, which is mainly based on the research results in European countries, it is proposed that HCA is classified into four molecular subtypes, i. e., type I: HNF1ct - inactivated HCA; type II: p - catenin - activated HCA; type III: inflammatory HCA; type IV: unclassified HCA. The research progress in the molecular pathology of HCA in foreign countries is reviewed. In addition, the main results of a recent study of 189 patients with HCA who underwent hepatectomy in our hospital are outlined. It was shown that 70% of HCA patients were middle - aged men, and 50% were overweight or obese; even female patients seldom had a history of long - term use of OCs. The gene sequencing showed that the mutational hotspots and frequency of HNF1ct in this group of HCA patients were significantly different from those reported in European countries, and no p - catenin and gp130 mutations were found. Therefore, based on the above results, it is considered that the population and pathogenesis of HCA are diiferent in China than in European countries. In light of the reports of malignant transformation of HCA in literature, a feasibility study is conducted to assess the risk of malignant transformation of HCA by detecting the microsatellite instability or loss of heterozygosity, which may provide a molecular pathological basis for developing individualized treatment strategies. [ABSTRACT FROM AUTHOR]